Key Takeaways

Ringworm infection responds to antifungals, but it requires more intensive treatment if it's on the scalp.

Despite its name, ringworm isn’t caused by a worm — but rather by a fungus. “The rash happens to come as a ring,” says Amy Kassouf, MD, a dermatologist with the Cleveland Clinic in Ohio. The name ringworm describes the characteristic circular shape, which can be red and scaly in appearance.

Ringworm occurs at various places on the body and is scientifically known as tinea, followed by a word denoting the area where the rash is visible; tinea capitus is a scalp infection, for example. In fact, ringworm that occurs in one person on one area can be transmitted to someone else and show up on a completely different body part, depending on how the fungus was transmitted.

The infection can spread via skin-to-skin contact, clothing, or surfaces where the fungus lives, such as in showers or locker rooms. It’s more common among people with compromised immune systems and can spread more easily among families (because of skin contact) or athletes (because of the locker room environment).

“Kids may have it on the scalp, and their mom will have it on her neck,” says Robin P. Gehris, MD, chief of pediatric dermatology at the University of Pittsburgh Medical Center's Children's Hospital of Pittsburgh. “When infants have tinea capitus and the mom snuggles with the infant, the mom can get it by direct inoculation to places like her neck and chest,” she explains.

Ringworm Treatment

While ringworm is irritating, it doesn’t come with severe complications.

In most cases, the rash is treated in the same way: with a topical antifungal treatment, such as Lotrimin (clotrimazole) or Lamisil (terbinafine). The one exception to the simple treatment rule is for a scalp infection, which occurs more commonly in children and is noticeable because a ring of hair loss will often occur in the infected area. Ringworm that reaches the scalp entails much more intensive treatment — typically six weeks of an oral antifungal medication rather than a topical cream.

While it’s necessary, the longer treatment course is unwelcome news to most patients, says Dr. Gehris. But topical creams won’t work on the scalp because the surface treatments don’t penetrate deeply enough. “Treating it yourself with over-the-counter antifungal creams, is not going to be effective because it’s on the scalp,” says Gehris.

Ringworm Transmission From Animals to People

Unlike some other infections, ringworm doesn’t only spread between people, but can also come from contact with an infected animal.

“I had a colleague who got it from holding a koala bear in Australia,” says Dr. Kassouf.

While most cases won’t come from such exotic sources, infection is a concern with household pets, who certainly rub up against human companions enough to spread ringworm to people within the house.

“Fungus is everywhere,” says Beth Goldstein, MD, a dermatologist in private practice in the Chapel Hill area and an adjunct at the University of North Carolina. “Small animals, like kittens and puppies, can get infected.”

Is It Ringworm or Something Else?

Because ringworm typically has a distinctive circular appearance, you may think you know what you have and treat it yourself with over-the-counter (OTC) remedies.

“Classically it looks like a red scaly patch where the center becomes clear,” says Dr. Goldstein.

But it can also look like eczema or other skin problems, so if your self-diagnosed rash doesn’t respond to OTC treatments, a visit to the doctor is a good idea.

The most important steps for you to take when you see an unexplained rash, says Adam Goldstein, MD, PhD, professor of family medicine at the University of North Carolina School of Medicine in Chapel Hill, are these: “Getting it diagnosed quickly, getting it treated so you’re not spreading it, and figuring out where you got it from.”

How to Prevent the Spread of Ringworm

Some basic steps families can take to avoid the spread of ringworm include being careful about what you share: Teach kids not to wear each other's hats, and make sure each family member uses their own comb and brush. Other basic hygiene practices, like not sharing razors, can help prevent the spread of ringworm. And athletes and gymgoers should be sure to wipe down or avoid sharing athletic equipment.

One of the most at-risk groups for ringworm are wrestlers, who come in contact with each other and with moist mats that harbor the fungus and facilitate its spread. In some cases, wrestlers may want to use antifungal treatments as part of a regular cleaning routine. Check with your doctor about this.

“In a high-risk sport like wrestling, consider showering right after with something that might be somewhat antifungal, such as Head & Shoulders or Selsun Blue shampoos as body wash,” says Gehris.

Unfortunately, she adds, “Sometimes you do everything right and you still get it.”